In the last several decades, the analytic field has widened considerably in scope. The therapeutic task is now seen by an increasing number of analysts to require that patient and analyst work together to strengthen, or to create, psychic structure that was previously weak, missing, or functionally inoperative. This view, which may apply to all patients, but is especially relevant to the treatment of non-neurotic patients and states of mind, stands in stark contrast to the more traditional assumption that the therapeutic task involves the uncovering of the unconscious dimension of a present pathological compromise formation that holds a potentially healthy ego in thrall. The contrast which this book calls attention to is that which exists roughly between formulations of psychic structure and functioning that were once assumed to have been sufficiently well explained by the hypotheses of Freud's topographic theory and those that were not. The former are modeled on neurosis and dream interpretation, where conflicts between relatively well-defined (saturated) and psychically represented desires were assumed to operate under the aegis of the pleasure-unpleasure principle.

With contributions from Anne Alvarez, Joshua Durban, Jeffrey L. Eaton, Bernard Golse, Didier Houzel, Howard B. Levine, Suzanne Maiello, Sylvain Missonnier, Bernd Nissen, Marganit Ofer, and Jani Santamaria. The capacity to create psychic representations is now understood to be a developmental achievement. Without it, meaning cannot be ascertained and this can lead to "psychic voids" and "unrepresented states", which can contribute to the development of autism and autistic spectrum disorders (ASD). Unrepresented states are also implicated and encountered in other, non-autistic, non-neurotic conditions, such as psychosomatic disorders, addictions, perversions, and primitive character disorders. The affects that unrepresented states produce or are associated with are often those of terror, emptiness, annihilation and despair. The organisation of the psyche consists of psychotic - i.e. unstructured - as well as neurotic parts of the mind; unintegrated as well as integrated areas; and unrepresented areas with little meaning as well as represented states consisting of specific ideas imbued with affect. Given this organisation, we should expect to find both an unstructured and a dynamic unconscious in all patients. This implies that, to some degree, unrepresented and unintegrated states are universal and will exist and be encountered in all of us. Consequently, the opportunities and challenges presented by the understanding and treatment of autism and ASD, where the unrepresented and its consequences (e.g. defensive organisations employed to protect against annihilation anxiety and catastrophic dread) can be encountered may offer us metaphors and clues relevant to aspects of the treatment of all patients, no matter what their dominant diagnoses may be. Packed with theory and helpful case studies, this carefully edited collection from an international array of experts in the field is essential reading for all practising clinicians.

Awarded first place in the 2017 AJN Book of the Year Awards in Psychiatric and Mental Health Nursing. This book introduces an innovative technique for therapeutic communication in mental health nursing, expanding the toolkit for nurses seeking to engage challenging patients who have not responded to more conventional therapeutic methods. Linking nursing communication to current research on metaphor and figuration, it is illustrated with accessible clinical examples. Metaphor is a key component of talk-based psychotherapies. But many of the patients whom nurses encounter in the inpatient setting are not good candidates for talk-based approaches, at least initially, because they are violent, withdrawn, highly regressed, or otherwise lacking a vocabulary to convey thoughts and feelings. This book offers specific clinical examples of an approach called the "gestural bridge." This is a method for structuring games and physical activities which connect metaphorically to a patient’s personal themes, activating narrative and observational agency and enabling an exchange of meaning to begin at a time when conventional language is not available. Rooted in what nursing theorists have called the "embodied" or "aesthetic" way of knowing, this approach is both specific and easily grasped. Drawing from contemporary work in literary theory, semiotics, metaphor theory, cognitive science, philosophy, linguistics, psychoanalysis, and the arts, Therapeutic Communication in Mental Health Nursing is important reading for advanced-level practitioners, students, and researchers interested in communication and relationship-building in nursing.

In this captivating volume, Bernd Nissen considers the multiplicity of nameless states, and the impact of their discovery on psychoanalytic theory and practice. The nameless is considered through a variety of lenses: trauma, unrepresented states, autistoid/autistic states, breakdown, non-existence, and unrepressed/unstructured consciousness. Nissen draws upon the work of Freud and Bion to inform his exploration of nameless states and the ways in which they might be located, understood and conceptualised. He illuminates the processes of transformation into the psychic and asks how nameless states can be psychically anchored. Clinical vignettes are used throughout to illustrate the consequences for treatment, as well as interpretations of complex holding situations. This book will be of interest to analysts both in practice and in training, as well as psychotherapists and mental health practitioners wishing to understand nameless states more deeply.

On Freud’s "The Uncanny" explores Freud’s 1919 essay of the same name and elaboration of the concept of the uncanny and how others or ‘the Other’ can impact on our selves. Catalina Bronstein and Christian Seulin bring together contributions from renowned psychoanalysts from different theoretical backgrounds, revisiting Freud’s ideas 100 years after they were first published and providing new perspectives that can inform clinical practice as well as shape the teaching of psychoanalysis. Covering key topics such as drives, clinical work, the psychoanalytic frame, and the influence of Ferenczi, On Freud’s "The Uncanny" will be useful for anyone wishing to understand the continued importance of the uncanny in contemporary psychoanalysis.

Dr James Grotstein (1925-2015) was the foremost Bion scholar, and one of the most noted and honoured psychoanalysts in the world. His prolific writings and generous encouragement to other analysts has had an enormous impact. He was among the first to examine Bion's most controversial concept - O - in particular the mystical aspects of O. The title of this book, Of Things Invisible To Mortal Sight: A Celebration of the Work of James S. Grotstein, inspired by a line from Milton's Paradise Lost (Book III), reflects Grotstein's decades-long examination of the most profound aspects of the human mind. Dr James Grotstein's erudition and depth of understanding made him one of the most revered psychoanalysts throughout the psychoanalytic world. He was well known and appreciated for his prolific writings, so it was only fitting to honour him through writing, and the fifteen articles in Of Things Invisible To Mortal Sight are written by esteemed analysts from Italy, Brazil, Argentina, Israel, and throughout the United States.